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County Health Rankings and Ratings

By Katharine Frohardt-Lane

Would you have guessed that, by one measure, the healthiest county overall in Michigan is Leelanau? Now, thanks to the “County Health Rankings and Ratings,” a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin’s Population Health Institute, you can investigate health measures for your county and state easily online.  Drawing on diverse data from sources such as  the National Center for Health Statistics, the American Community Survey, and the Environmental Protection Agency, the “County Health Rankings and Ratings” project annually rates and ranks each U.S. county on four health factors and their component measures and on five health outcomes along with an overall rating and ranking.   Rankings are grouped into quartiles and  mapped, with a map for each of the measures.  For example, here is a map of the overall county rankings for Michigan:

The four health factors with examples of their component measures are:

Health behaviors:  physical inactivity, teen birth rate, smoking
Clinical care:  percentage uninsured, availability of primary care physicians
Social and economic factors: children in poverty, violent crime rate
Physical environment: air pollution, access to recreational facilities, access to healthy food

Each factor and each component is rated, ranked, and mapped for every county within a state.  Comparing rankings across factors and measures is illuminating.  On health behavior, the southeast Michigan counties of Washtenaw, Livingston, and Oakland are in the top ten counties for good health behaviors, but no southeast Michigan county is in the top ten or even the top quartile (that is, top fourth) on the physical environment factor.  The maps below display the rankings on these two factors within quartiles.

Physical Environment

Health Behaviors

Counties are rated and ranked on five health outcomes as well.  These are: (1) preventable deaths (years of potential life lost); (2) poor physical health days; (3) poor mental health days; (4) low birthweight; and (5) poor or fair health.

While the website is a delight for the simply curious, it is a treasure trove of data for those seeking to improve the health of their community.  The “County Health Roadmaps” on the same website provides resources for identifying factors to work on for maximal impact.  Health researchers, too, are rewarded with ample references and  thoughtful discussions of each measure, covering why it was chosen, its strengths, and its limitations.